Health New Zealand has confirmed the bulk of its deficit is down to funding nursing staff - around 3000 nurses were hired last year.
Te Whatu Ora is extending its cost cutting for another three years, offering voluntary redundancies, after a $700m deficit in the past financial year.
It forecasts the deficit this current financial year will be $1.1 billion dollars.
Chief executive Margie Apa told Morning Report almost $800 million of that is in personnel costs and a nurse ET had gone up, she said.
"We have a $797 million in personnel costs that are greater than budget. Now not all of that is nursing, we did recruit more in other areas as well...
Health NZ to extend cost cutting measures for three years
"Of the 3400 nurses that were ahead of budget our projections outwards show that we were probably be growing at that rate but it was much sooner than what we can afford this year."
Nurses were needed but Health NZ needs to look at where they are distributed, she said. "There are nursing gaps in areas."
"For Health New Zealand, it's about living in the budget that we've got. Ensuring that we've got the distribution of these resources to achieve a national health target and the delivery that we know New Zealanders need to get access to healthcare and so that is the key approach that we've taken..."
Health promotion, for example, was an area Health NZ was looking to rethink, Apa said.
Asked if she could guarantee that key public health messaging would still get through to people, Apa said those messages aren't always delivered by the area that would be affected.
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